- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,506.31 / $7,888.40 / $9,094.86
| Facility | | $6,506.31 | $7,888.40 | $9,094.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,833.57 / $18,208.31 / $25,013.86
| Facility | | $9,833.57 | $18,208.31 | $25,013.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,787.82 / $9,212.61 / $15,811.73
| Facility | | $5,787.82 | $9,212.61 | $15,811.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,156.00 / $5,238.97 / $13,958.63
| Facility | | $2,156.00 | $5,238.97 | $13,958.63 |